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Published in: Head & Neck Oncology 1/2011

Open Access 01-12-2011 | Research

The submental flap for oral cavity reconstruction: Extended indications and technical refinements

Authors: Ayman A Amin, Mostafa A Sakkary, Ashraf A Khalil, Mohammmed A Rifaat, Sherif B Zayed

Published in: Head & Neck Oncology | Issue 1/2011

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Abstract

Background and purpose

The submental flap is gaining popularity as a simple technique for reconstruction of small to moderate size defects of the oral cavity. However, its role in composite defects involving the jaw is not clearly defined. Indeed, controversy exists about the flap's interference with an oncologically sound neck dissection

Patients and Methods

A total of 21 patients with oral cavity cancers over a three year period were included. All patients underwent surgical resection and immediate reconstruction with submental flap except one patient who had delayed reconstruction with reversed flap. The flap was used for reconstruction of intra-oral soft tissue defect in 13 patients and composite defects in 8 patients.

Results

Of 21 patients 12 were males and 9 were females, age ranged from 32 to 83 years. The primary tumor sites included buccal mucosa (7), tongue (4), alveolar margin (3), floor of mouth (5) and lip (2). Eventually in this study, we adopted completing the neck dissection first before flap harvest. Complete flap loss occurred in 2 whereas 3 patients had partial flap loss. Follow up ranged from 3 to 44 months, one patient died from metastatic disease. Four patients developed neck recurrences.

Conclusion

The submental flap is a valid option for reconstruction of intra-oral soft tissue as well as composite oral defects particularly in elderly patients. However, oncologically sound neck dissection should be assured.
Appendix
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Literature
1.
go back to reference Jemal A, Siegel R, Ward E, et al: Cancer statistics, 2006. CA Cancer J Clin. 2006, 56 (2): 106-30. 10.3322/canjclin.56.2.106.CrossRefPubMed Jemal A, Siegel R, Ward E, et al: Cancer statistics, 2006. CA Cancer J Clin. 2006, 56 (2): 106-30. 10.3322/canjclin.56.2.106.CrossRefPubMed
2.
go back to reference Shah JP, Medina JE, Shaha AR, et al: Cervical lymph node metastasis. Curr Probl Surg. 1993, 30 (3): 273-344.CrossRef Shah JP, Medina JE, Shaha AR, et al: Cervical lymph node metastasis. Curr Probl Surg. 1993, 30 (3): 273-344.CrossRef
3.
go back to reference Hilda ES, Sasan K, Nancy L, Snehal GP: Oral Cavity and Oropharynx Tumors. Radiol Clin N Am. 2007, 45: 1-20. 10.1016/j.rcl.2006.10.010.CrossRef Hilda ES, Sasan K, Nancy L, Snehal GP: Oral Cavity and Oropharynx Tumors. Radiol Clin N Am. 2007, 45: 1-20. 10.1016/j.rcl.2006.10.010.CrossRef
4.
go back to reference Sebastian P, Thomas S, Varghese BT, Iype EM, Balagopal PG, Mathew PC: The submental island flap for reconstruction of intraoral defects in oral cancer patients. Oral Oncol. 2008, 44 (11): 1014-8. 10.1016/j.oraloncology.2008.02.013. Epub 2008 Jul 11CrossRefPubMed Sebastian P, Thomas S, Varghese BT, Iype EM, Balagopal PG, Mathew PC: The submental island flap for reconstruction of intraoral defects in oral cancer patients. Oral Oncol. 2008, 44 (11): 1014-8. 10.1016/j.oraloncology.2008.02.013. Epub 2008 Jul 11CrossRefPubMed
5.
go back to reference Berenholz L, Kessler A, Segal S: Platysma myocutaneous flap for intraoral reconstruction: an option in the compromised patient. Int J Oral Maxillofac Surg. 1999, 28 (4): 285-7. 10.1016/S0901-5027(99)80159-3. ReviewCrossRefPubMed Berenholz L, Kessler A, Segal S: Platysma myocutaneous flap for intraoral reconstruction: an option in the compromised patient. Int J Oral Maxillofac Surg. 1999, 28 (4): 285-7. 10.1016/S0901-5027(99)80159-3. ReviewCrossRefPubMed
6.
go back to reference Sarah R, James N: Submental Myocutaneous Flap Reconstruction for Oral Defect (Poster presentation). (presenter) Sarah R, James N: Submental Myocutaneous Flap Reconstruction for Oral Defect (Poster presentation). (presenter)
7.
go back to reference Martin D, Pascal JF, Baudet J, et al: The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg. 1993, 92: 867-73.CrossRefPubMed Martin D, Pascal JF, Baudet J, et al: The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg. 1993, 92: 867-73.CrossRefPubMed
8.
go back to reference Sterne GD, Januszkiwicz JS, Hall PN, Bardsley AF: The submental island flap. Brit J Plast Surg. 1996, 49: 85-9. 10.1016/S0007-1226(96)90078-8.CrossRefPubMed Sterne GD, Januszkiwicz JS, Hall PN, Bardsley AF: The submental island flap. Brit J Plast Surg. 1996, 49: 85-9. 10.1016/S0007-1226(96)90078-8.CrossRefPubMed
9.
go back to reference Demir Z, Kurtay A, Sahin U, Velidedeoglu H, Celebioglu S: Hair- bearing submental artery island flap for reconstruction of mustache and beard. Plast Reconstr Surg. 2003, 112: 423-429. 10.1097/01.PRS.0000070520.96829.85.CrossRefPubMed Demir Z, Kurtay A, Sahin U, Velidedeoglu H, Celebioglu S: Hair- bearing submental artery island flap for reconstruction of mustache and beard. Plast Reconstr Surg. 2003, 112: 423-429. 10.1097/01.PRS.0000070520.96829.85.CrossRefPubMed
10.
go back to reference Kim JT, Kim SK, Koshima I, Moriguchi T: An anatomic study and clinical applications of the reversed submental perforator-based island flap. Plast Reconstr Surg. 2002, 109: 2204-2210. 10.1097/00006534-200206000-00004.CrossRefPubMed Kim JT, Kim SK, Koshima I, Moriguchi T: An anatomic study and clinical applications of the reversed submental perforator-based island flap. Plast Reconstr Surg. 2002, 109: 2204-2210. 10.1097/00006534-200206000-00004.CrossRefPubMed
11.
go back to reference Demir Z, Velidedeoglu H, Celebioglu S: Repair of pharyngocutaneous fistulas with the submental artery island flap. Plast Reconstr Surg. 2005, 115: 38-44. 10.1097/01.PRS.0000153040.15640.2F.CrossRefPubMed Demir Z, Velidedeoglu H, Celebioglu S: Repair of pharyngocutaneous fistulas with the submental artery island flap. Plast Reconstr Surg. 2005, 115: 38-44. 10.1097/01.PRS.0000153040.15640.2F.CrossRefPubMed
12.
go back to reference Salgado CJ, Mardini S, Chen HC, Chen S: Critical oropharyngocutaneous fistulas after microsurgical head and neck reconstruction: Indications for management using the "tissue-plug" technique. Plast Reconstr Surg. 2003, 112: 957-963. 10.1097/01.PRS.0000076219.62225.07.CrossRefPubMed Salgado CJ, Mardini S, Chen HC, Chen S: Critical oropharyngocutaneous fistulas after microsurgical head and neck reconstruction: Indications for management using the "tissue-plug" technique. Plast Reconstr Surg. 2003, 112: 957-963. 10.1097/01.PRS.0000076219.62225.07.CrossRefPubMed
13.
go back to reference Geden EM, Buchbinder D, Urken ML: The submental island flap for palatal reconstruction: A novel technique. J Oral Maxillofac Surg. 2004, 62: 387-390. 10.1016/j.joms.2003.06.009.CrossRef Geden EM, Buchbinder D, Urken ML: The submental island flap for palatal reconstruction: A novel technique. J Oral Maxillofac Surg. 2004, 62: 387-390. 10.1016/j.joms.2003.06.009.CrossRef
14.
go back to reference Tan O, Atik B, Parmaksizoglu D: Soft-tissue augmentation of the middle and lower face using the deepithelialized submental flap. Plast Reconstr Surg. 2007, 119: 873-879. 10.1097/01.prs.0000252002.76466.cf.CrossRefPubMed Tan O, Atik B, Parmaksizoglu D: Soft-tissue augmentation of the middle and lower face using the deepithelialized submental flap. Plast Reconstr Surg. 2007, 119: 873-879. 10.1097/01.prs.0000252002.76466.cf.CrossRefPubMed
15.
go back to reference Yilmaz M, Menderes A, Barutcu A: Submental artery island flap for reconstruction of the lower and mid face. Ann Plast Surg. 1997, 39: 30-35. 10.1097/00000637-199707000-00005.CrossRefPubMed Yilmaz M, Menderes A, Barutcu A: Submental artery island flap for reconstruction of the lower and mid face. Ann Plast Surg. 1997, 39: 30-35. 10.1097/00000637-199707000-00005.CrossRefPubMed
16.
go back to reference Faltaous AA, Yetman RJ: The submental artery flap: An anatomic study. Plast Reconstr Surg. 1996, 97: 56-62. 10.1097/00006534-199601000-00008.CrossRefPubMed Faltaous AA, Yetman RJ: The submental artery flap: An anatomic study. Plast Reconstr Surg. 1996, 97: 56-62. 10.1097/00006534-199601000-00008.CrossRefPubMed
17.
go back to reference Magden O, Edizer M, Tayfur V, Atabey A: Anatomic study of the vasculature of the submental artery flap. Plast Reconstr Surg. 2004, 114: 1719-1723. 10.1097/01.PRS.0000142479.52061.7D.CrossRefPubMed Magden O, Edizer M, Tayfur V, Atabey A: Anatomic study of the vasculature of the submental artery flap. Plast Reconstr Surg. 2004, 114: 1719-1723. 10.1097/01.PRS.0000142479.52061.7D.CrossRefPubMed
18.
go back to reference Chow TL, Chan TT, Chow TK, Fung SC, Lam SH: Reconstruction with submental flap for aggressive orofacial cancer. Plast Reconstr Surg. 2007, 120: 431-436. 10.1097/01.prs.0000267343.10982.dc.CrossRefPubMed Chow TL, Chan TT, Chow TK, Fung SC, Lam SH: Reconstruction with submental flap for aggressive orofacial cancer. Plast Reconstr Surg. 2007, 120: 431-436. 10.1097/01.prs.0000267343.10982.dc.CrossRefPubMed
19.
go back to reference Merten SL, Jiang RP, Caminer D: The submental artery island flap for head and neck reconstruction. Aust N Z J Surg. 2002, 72: 121-124. 10.1046/j.1445-2197.2002.02318.x.CrossRef Merten SL, Jiang RP, Caminer D: The submental artery island flap for head and neck reconstruction. Aust N Z J Surg. 2002, 72: 121-124. 10.1046/j.1445-2197.2002.02318.x.CrossRef
20.
go back to reference Taghinia AH, Movassaghi KD, Wang AX, Pribaz JJ: Reconstruction of the Upper Aerodigestive Tract with the Submental Artery Flap. Plast Reconstr Surg. 2009, 123 (2): 562-570. 10.1097/PRS.0b013e3181977fe4.CrossRefPubMed Taghinia AH, Movassaghi KD, Wang AX, Pribaz JJ: Reconstruction of the Upper Aerodigestive Tract with the Submental Artery Flap. Plast Reconstr Surg. 2009, 123 (2): 562-570. 10.1097/PRS.0b013e3181977fe4.CrossRefPubMed
21.
go back to reference Pistre V, Pelissier P, Martin D, Lim A, Baudet J: Ten years of experience with the submental flap. Plast Reconstr Surg. 2001, 108: 1576-158. 10.1097/00006534-200111000-00021.CrossRefPubMed Pistre V, Pelissier P, Martin D, Lim A, Baudet J: Ten years of experience with the submental flap. Plast Reconstr Surg. 2001, 108: 1576-158. 10.1097/00006534-200111000-00021.CrossRefPubMed
22.
go back to reference Multinu A, Ferrari S, Bianchi B, et al: The submental island flap in head and neck reconstruction. Int J Oral Maxillofac Surg. 2007, 36: 716-720. 10.1016/j.ijom.2007.03.008.CrossRefPubMed Multinu A, Ferrari S, Bianchi B, et al: The submental island flap in head and neck reconstruction. Int J Oral Maxillofac Surg. 2007, 36: 716-720. 10.1016/j.ijom.2007.03.008.CrossRefPubMed
23.
go back to reference Abouchadi A, Capon-Degardin N, PatenˆOtre P, et al: The submental flap in facial reconstruction: advantages and limitations. J Oral Maxillofac Surg. 2007, 65: 863-9. 10.1016/j.joms.2006.05.063.CrossRefPubMed Abouchadi A, Capon-Degardin N, PatenˆOtre P, et al: The submental flap in facial reconstruction: advantages and limitations. J Oral Maxillofac Surg. 2007, 65: 863-9. 10.1016/j.joms.2006.05.063.CrossRefPubMed
Metadata
Title
The submental flap for oral cavity reconstruction: Extended indications and technical refinements
Authors
Ayman A Amin
Mostafa A Sakkary
Ashraf A Khalil
Mohammmed A Rifaat
Sherif B Zayed
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Head & Neck Oncology / Issue 1/2011
Electronic ISSN: 1758-3284
DOI
https://doi.org/10.1186/1758-3284-3-51

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